Asked by: Taiwo Owatemi (Labour - Coventry North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she plans to take to help increase the (a) stock of colonoscopy equipment, (b) number of colonoscopy facilities and (c) number of trained staff; and what other steps she plans to take to increase the use of colonoscopies in detecting bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is not currently planning to take steps to increase the stock of colonoscopy equipment. £2.3 billion was awarded at the Spending Review 2021 to transform diagnostic services over the next three years. Within this funding, NHS England is delivering an expected net increase uplift of 67 endoscopy rooms in acute trusts or in non-community diagnostic centre (CDC) developments. In CDCs, current plans are for 46 sites to be delivering endoscopies from March 2025, of which, 39 will deliver colonoscopies. This will help to support integrated care boards not currently meeting the optimal capacity of 3.5 rooms per 100,000 people over 50 years old, to do so.
NHS England will continue to deliver initiatives to train around 100 clinical endoscopists per annum to be capable of delivering colonoscopies and other gastrointestinal procedures. In addition to this NHS England is also training doctors, such as gastroenterologists, in the same procedures and continuing to develop, implement and improve immersive and rapid colonoscopy training through endoscopy academies.
As of October 2023, there are over 3,200 full-time equivalent doctors working in the specialty of gastroenterology within National Health Service trusts and other core organisations in England. This is over 100, or 4.3%, more than in 2022, over 500, or 20.1%, more than in 2019, and almost 1,400, or 75.2%, more than in 2010.
To improve bowel cancer diagnosis, the NHS has implemented timed cancer pathways for gastro-intestinal (GI) disease. This includes the implementation of Faecal Immunochemical Testing for those with symptoms in the lower GI, to prevent these patients from having unnecessary colonoscopies, freeing up capacity for these procedures and ensuring the most urgent symptomatic patients are seen more quickly.
Asked by: Taiwo Owatemi (Labour - Coventry North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure that people with Lynch Syndrome are (a) informed of their condition and (b) made aware of their increased risk of bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England, through the NHS Genomic Medicine Service, has launched a national transformation project to ensure more patients with Lynch syndrome are identified and benefit from regular check-ups, earlier interventions, and more targeted treatment, such as combinations of immunotherapy, chemotherapy and surgeries.
People aged between 25 and 75 years old identified as having Lynch Syndrome will be included in the surveillance arm of the National Health Service bowel cancer screening programme, and will be offered a colonoscopy every two years.
The national programme ensures all people diagnosed with bowel and endometrial are offered genomic testing, with a diagnosis for Lynch syndrome not only helping to guide more personalised cancer treatment but enabling their families and relatives to be offered testing too.
Asked by: Kirsten Oswald (Scottish National Party - East Renfrewshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of women who (a) have and (b) do not have multiple sclerosis attended (i) cancer screening appointments, (ii) mammograms and (iii) cervical screening appointments in each of the last five years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
National Health Service screening programmes do not collect data on an individual’s long-term condition, and therefore no data is available on what proportion of women who have multiple sclerosis, participate in cancer screening programmes.
Under the Equality Act 2010, and the Health and Social Care Act 2012, NHS screening providers have a legal duty to make sure screening services are accessible to everyone, including people with long term conditions, who may have issues with access.
The following table provides data on the percentage of coverage for the three cancer screening programmes, breast, cervical and bowel, within the age groups invited for NHS screenings, in England over the last five years:
| 2016/17 | 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 |
Breast Screening – ages 50 to 71 years old | 74.9% | 74.6% | 74.2% | 64.2% | 65.3% | 66.4% |
Cervical Screening – ages 25 to 64 years old | 71.4% | 71.9% | 72.2% | 70.2% | 69.9% | 68.7% |
Bowel Screening – ages 60 to 74 years old | 59.2% | 59.5% | 60.5% | 64.3% | 66.1% | 70.3% |
Note: Data for bowel cancer screening is not separated based on sex.
Asked by: Grahame Morris (Labour - Easington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, which Minister in her Department is responsible for delivery of (a) cancer screening programmes and (b) the NHS public health Section 7A agreement.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
My role as the Minister of State for Health and Secondary Care includes responsibility for major diseases including cancer, and for screening.
In accordance with the NHS Public Health Functions Agreement (made under section 7A of the NHS Act 2006) NHS England is responsible for providing or securing the provision of breast, bowel and cervical screening programmes and other specified public health services.
My Rt. Hon friend, Andrea Leadsom MP, the Parliamentary Under Secretary of State for Public Health, Start for Life and Primary Care, has led ministerial responsibility for arrangements under section 7A.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to her Department's press release entitled Digital pathology to improve cancer screening and save lives, published on 5 January 2024, what additional training will be given to pathologists working to enable the quick uptake of new technology.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Following the recommendation from the UK National Screening Committee to support the use of digital pathology in the National Health Service cervical, breast and bowel cancer screening programmes, NHS England are investing in and working with the Royal College of Pathologists in the on-going development of an online Pathology Portal.
This digital learning platform will support trainees and established pathology practitioners in digital pathology to ensure that digital learning materials are available to the multi-professional workforce.
NHS England plans to issue guidance at the end of January 2024 for the three NHS Cancer Screening Programmes, to support local providers of histopathology services who wish to implement digital pathology for the reporting of screening cases.
Asked by: Navendu Mishra (Labour - Stockport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 November 2023 to Question 3997 on Incontinence: Health Services, whether her Department plans to engage stakeholders during the course of the National Bladder and Bowel Health Project.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
There have been no formal plans for stakeholder engagement set out at this stage. However, the Department remains open to future engagement with bladder and bowel health stakeholders.
Beyond the project in question, the Department continues to engage with stakeholders including commissioners, providers, and clinicians and also cancer charities on Bowel Cancer screening, including a planned meeting with UK National Screening Committee on bowel cancer screening in January 2024.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken since the 2019 publication of 'Asymptomatic Inflammatory Bowel Disease and Colorectal Cancer Screening Programs' by Farrukh and Mayberry in Gastrointestinal Disorders in respect of its findings of differences and discrimination in the delivery of (1) colorectal screening in healthy people, and (2) care and surveillance of patients with inflammatory bowel disease.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
If someone is detected during bowel screening to have blood in their faeces, then found to have inflammatory bowel disease (IBD) through follow up tests they are referred to the symptomatic service for onward management and surveillance. They are then offered screening every two years along with ongoing monitoring and surveillance, the timeframes of which are detailed below.
The National Institute for Health and Care Excellence (NICE)’s guideline on colorectal cancer prevention was published in March 2011 and updated in September 2022. It recommends using colonoscopy to check for signs of bowel cancer in people aged 18 years old and over with ulcerative colitis or Crohn’s disease. The guidance recommends that follow-up and ongoing colonoscopic surveillance should be arranged at regular intervals for people with IBD and tubular adenoma as follows:
- Low risk: offer colonoscopy at five years;
- Intermediate risk: offer colonoscopy at three years; or
- High risk: offer colonoscopy at one year.
A copy of the guidance is attached.
We expect integrated care boards (ICBs) to have due regard to relevant NICE guidelines when commissioning services. It is the responsibility of ICBs to make available appropriate provision to meet the health and care needs of their local population, in line with these NICE guidelines.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what plans they have to hold discussions with Care Quality Commission, NHS England and integrated care boards to reduce differences and discrimination in the delivery of (1) colorectal screening in healthy people, and (2) care and surveillance of patients with inflammatory bowel disease.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
There are currently no plans for specific discussion on this matter. However, the subject may be raised at programme boards and other regular conversations between officials at NHS England and the Department.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what consideration they have given to the possibility and potential of implementing routine assessments into the prevalence and geographic and socioeconomic disparities of people with (1) Crohn’s disease, and (2) ulcerative colitis to inform healthcare investment and planning decisions.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Information is already collected on a range of bowel conditions, including Hospital Episode Statistics, through the Model Health System, and data from the NHS Bowel Cancer Screening Programme. These support clinicians and commissioners plan and prioritise care for people with bowel conditions, considering health disparities and patient needs.
Asked by: Gregory Campbell (Democratic Unionist Party - East Londonderry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when she plans to reduce the minimum age for bowel screening to 50.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England started the lowering of age for bowel cancer screening in April 2021. The following table shows the rollout plan for the bowel screening, keeping in mind that the timeline may differ slightly from region to region:
Cohort age at first invitation | Year invitations start |
56 years old | 2021/22 |
58 years old | 2022/23 |
54 years old | 2023/24 |
50 and 52 years old | 2024/25 |